Bloodborne Pathogens

Bloodborne pathogens are pathogenic microorganisms present in human blood that can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV). Hepatitis B can survive in dried blood specimens for several days.

Definitions for bloodborne pathogens, Other Potentially Infectious Materials (OPIM), and occupational exposure are found in [1910.1030(b)].

Potential Hazard

Exposure of laboratory employees to bloodborne pathogens while handling contaminated lab samples such as blood or other body fluids (i.e., cerebrospinal fluid, and semen).

Possible Solutions

Compliance with the Bloodborne Pathogens Standard. For example:

• Wear appropriate PPE as required by the Bloodborne Pathogens Standard 1910.1030Gloves must be worn when hand contact with blood, mucous membranes, OPIM, or non-intact skin is anticipated, or when handling contaminated items or surfaces [1910.1030(d)(3)(ix)].
  
  

• Provide effective engineering and work practice controls to help remove or isolate exposures to blood and bloodborne pathogens [1910.1030(c)(1)(iv), 1910.1030CPL 2-2.69]. 
  
  

• Employers must offer the Hepatitis B vaccination under the supervision of a licensed physician at no cost to all employees who have occupational exposure to blood or OPIM [1910.1030(2)].

For additional information see HealthCare Wide Hazards - Bloodborne Pathogens.

For additional information see HealthCare Wide Hazards - Bloodborne Pathogens.

Additional Bloodborne Pathogen Standard requirements apply for HIV and HBV Research Laboratories. They do not apply to clinical or diagnostic laboratories engaged solely in the analysis of blood, tissues, or organs [1910.1030(e)(i)]. Some of these additional requirements include:

• Waste materials:

  • All regulated waste shall either be incinerated or decontaminated by a method such as autoclaving known to effectively destroy bloodborne pathogens [1910.1030(e)(2)(i)]. 

  • Contaminated materials that are to be decontaminated at a site away from the work area shall be placed in a durable, leakproof, labeled or color-coded container that is closed before being removed from the work area [1910.1030(e)(2)(ii)(B)].
    

  Access:

  • Laboratory doors shall be kept closed when work involving HIV or HBV is in progress [1910.1030(e)(2)(ii)(A)].

  • Access to the work area shall be limited to authorized persons. Written policies and procedures shall be established whereby only persons who have been advised of the potential biohazard, who meet any specific entry requirements, and who comply with all entry and exit procedures shall be allowed to enter the work areas and animal rooms [1910.1030(e)(2)(ii)(C)].

  • Access doors to the work area or containment module shall be self-closing [1910.1030The work areas shall be separated from areas that are open to unrestricted traffic flow within the building. Passage through two sets of doors shall be the basic requirement for entry into the work area from access corridors or other contiguous areas. Physical separation of the high-containment work area from access corridors or other areas or activities may also be provided by a double-doored clothes-change room (showers may be included), airlock, or other access facility that requires passing through two sets of doors before entering the work area [1910.1030The surfaces of doors, walls, floors and ceilings in the work area shall be water resistant so that they can be easily cleaned. Penetrations in these surfaces shall be sealed or capable of being sealed to facilitate decontamination [1910.1030Labels:

    • When other potentially infectious materials or infected animals are present in the work area or containment module, a hazard warning sign incorporating the universal biohazard symbol shall be posted on all access doors. The hazard warning sign shall comply with paragraph 1910.1030(g)(1)(ii) of this standard [1910.1030(e)(2)(ii)(D)].
      

    Engineering Controls and Work Practice:

    • All activities involving other potentially infectious materials shall be conducted in biological safety cabinets or other physical-containment devices within the containment module. No work with these other potentially infectious materials shall be conducted on the open bench [1910.1030(e)(2)(ii)(E)].

    • Certified biological safety cabinets (Class I, II, or III) or other appropriate combinations of personal protection or physical containment devices, such as special protective clothing, respirators, centrifuge safety cups, sealed centrifuge rotors, and containment caging for animals, shall be used for all activities with other potentially infectious materials that pose a threat of exposure to droplets, splashes, spills, or aerosols [1910.1030(e)(2)(iii)(A)].

    • Each work area shall contain a sink for washing hands and a readily available eye wash facility. The sink shall be foot, elbow, or automatically operated and shall be located near the exit door of the work area [1910.1030(e)(4)(iii)].

    • Each laboratory shall contain a facility for hand washing and an eye wash facility which is readily available within the work area [1910.1030(e)(3)(i)].

  Additional Information

  • Biosafety Manual, U.S. Department of Health and Human Services Centers for Disease Control and Prevention. Fourth Edition, May 1999.

   

Tuberculosis (TB)

In 1997 OSHA estimated that more than 5.3 million workers in more than 100,000 hospitals, homeless shelters, long-term care facilities for the elderly, detention facilities, certain laboratories and other work settings have a high risk of TB infection. In the United States, 13 million adults are presently believed to be infected with TB, and 22,813 have active cases that were reported in the U.S. in 1995. The CDC considers workers in medical laboratories that handle M. tuberculosis to be at high risk for occupational transmission of TB. The potential of contracting TB among persons who work with TB in the lab is three to five times greater than among lab personnel that do not work with TB bacterium.

Potential Hazard

Exposure of laboratory employees to TB from working with specimens (e.g., acid fast bacilli smears), that may contain tuberculosis. Other fluids that may be potential sources of TB are sputum, cerebrospinal fluid urine, and fluids collected from gastric or bronchial lavage.

Possible Solutions

• All cultures or specimens suspected of containing TB bacilli must be manipulated in settings where specific engineering controls, administrative procedures, and appropriate personal work practices ensure containment of the organism and protection of the workers These practices should address issues including: 
  
  

  • Biosafety Level: In order for a laboratory to handle TB sputum and TB materials, the laboratory must operate at a biosafety level of 2+ or 3.
    
    

  • Controlled access, anterooms, sealed windows, directional airflow, preventing recirculation of laboratory exhaust air, filtration of exhaust air before discharge to the outside, and thimble exhaust connections for biological safety. 
    
    

  • The use of biological safety cabinets whenever working with infectious materials that have a chance of aerosolizing. Processes that can expose employees to aerosolized materials include:
    
    

    • Pouring liquid cultures
      
      

    • Using fixed-volume automatic pipettors
      
      

    • Mixing liquid cultures with a pipette
      
      

    • Preparing specimens and culture smears
      
      

    • Dropping and spilling tubes containing suspensions of bacilli

For additional information, see HealthCare Wide Hazards - Tuberculosis.

Additional Information

• Goals for Working Safely with Mycobacterium Tuberculosis in Clinical, Public Health, and Research Facilities. Biosafety in Microbiological and Biomedical Laboratories 4th Edition.